Petrous bone cholesteatoma (PBC): report of 94 cases of PBC with focus on intraoperative endoscopic assistance, and systematic review of the literature.

Autor: Rueda Vega M; Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46. 3rd Floor, 28007, Madrid, CP, Spain. monica.ruedavega@gmail.com., López Granados C; Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46. 3rd Floor, 28007, Madrid, CP, Spain., Martín Oviedo C; Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46. 3rd Floor, 28007, Madrid, CP, Spain., Arístegui Torrano I; Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46. 3rd Floor, 28007, Madrid, CP, Spain., Arístegui Ruiz M; Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón, C/Doctor Esquerdo, 46. 3rd Floor, 28007, Madrid, CP, Spain.
Jazyk: angličtina
Zdroj: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery [Eur Arch Otorhinolaryngol] 2024 Dec 19. Date of Electronic Publication: 2024 Dec 19.
DOI: 10.1007/s00405-024-09144-4
Abstrakt: Purpose: The aim of this study is to assess the clinical characteristics, classification, surgical approaches, interventional strategies, and treatment outcomes of patients with petrous bone cholesteatoma (PBC).
Methods: Observational retrospective study of patients with PBC managed by the senior author of this paper between 1995 and 2024 in a tertiary referral center. A literature review was made, identifying 16 articles. Clinical presentations, Sanna's classification, pre- and post-surgical facial function and audiometry, surgical approach and intraoperative endoscopic assistance, postoperative complications, and recurrence rates were reported.
Results: We report on a large series of 94 cases managed by the senior author. The most common type was supralabyrinthine PBCs (40.43%; 38 cases), followed by massive (18.09%; 17). Hearing loss was present in almost all the patients (98.91%). The most frequent approaches were the modified translabyrinthine approach (24.51%; 25), the subtotal petrosectomy (22.55%; 23) and the transotic approach (18.63%; 19). In 11 patients the approach was assisted by the use of an endoscope. Recurrence of PBC was identified in 8 cases (8.51%) that were surgically resolved. Additionally, we report a review of the literature (16 articles).
Conclusions: We focus on the introduction of endoscopic assisted techniques that may help in reducing the rate of residual and avoid rerouting of the facial nerve. At the same time, we encourage techniques that include elimination of the middle ear through a subtotal petrosectomy, as they are essential to protect vital structures that have been exposed by the disease or by the surgical technique.
Competing Interests: Declarations. Conflict of interest: The authors declare that they have no conflict of interest.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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